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在含硬脂胺的阳离子脂质体中使用两性霉素B完全治愈实验性内脏利什曼病涉及白细胞介素-10的下调和良好的T细胞反应。

Complete cure of experimental visceral leishmaniasis with amphotericin B in stearylamine-bearing cationic liposomes involves down-regulation of IL-10 and favorable T cell responses.

作者信息

Banerjee Antara, De Manjarika, Ali Nahid

机构信息

Infectious Diseases and Immunology Division, Indian Institute of Chemical Biology, Kolkata, India.

出版信息

J Immunol. 2008 Jul 15;181(2):1386-98. doi: 10.4049/jimmunol.181.2.1386.

Abstract

Visceral leishmaniasis caused by Leishmania donovani is a life-threatening disease involving uncontrolled parasitization of liver, spleen, and bone marrow. Most available drugs are toxic. Moreover, relapse after seemingly successful therapy remains a chronic problem. In this study, we evaluated a new therapeutic approach based on combination of a low dose of amphotericin B (AmB) in association with suboptimum dose of stearylamine (SA)-bearing cationic liposomes, itself having leishmanicidal activity. We demonstrate that a single-shot therapy with this formulation caused clearance of parasites from liver and spleen below the level of detection in the selected piece of the organs of BALB/c mice. The combination was superior to free AmB and AmBisome for therapy, as well as for prevention of relapse and reinfection. Besides having better killing activity, AmB in SA liposomes, in contrast to AmBisome, maintained the immunomodulatory effect of free AmB on CD4(+) and CD8(+) T cells for IFN-gamma production, at the same time reducing the toxic effects of the drug, reflected through decline in TNF-alpha. In addition, IL-10 was down-regulated to almost negligible levels, most efficiently through therapy with SA-bearing cationic liposomes-AmB. This IL-10-deficient environment of IFN-gamma-secreting T cells probably up-regulated the enhanced IL-12 and NO production observed in splenic culture supernatants of these mice, correlating with prolonged disease suppression better than free AmB and AmBisome. The ability of the formulation to elicit protective immunity was reconfirmed in a prophylactic model. Our results emphasize the requirement of effective immune stimulation, additionally, by antileishmanials for persistent disease protection, demonstrated by this liposomal AmB formulation.

摘要

由杜氏利什曼原虫引起的内脏利什曼病是一种危及生命的疾病,涉及肝脏、脾脏和骨髓的寄生虫不受控制地寄生。大多数现有药物都有毒性。此外,看似成功治疗后的复发仍然是一个长期问题。在本研究中,我们评估了一种新的治疗方法,该方法基于低剂量两性霉素B(AmB)与次最佳剂量的含硬脂胺(SA)阳离子脂质体联合使用,后者本身具有杀利什曼原虫活性。我们证明,用这种制剂进行单次治疗可使BALB/c小鼠所选器官切片中肝脏和脾脏的寄生虫清除至检测水平以下。该组合在治疗以及预防复发和再感染方面优于游离AmB和两性霉素脂质体。与两性霉素脂质体相比,SA脂质体中的AmB除了具有更好的杀伤活性外,还维持了游离AmB对CD4(+)和CD8(+) T细胞产生IFN-γ的免疫调节作用,同时降低了药物的毒性作用,这通过TNF-α的下降得以体现。此外,IL-10被下调至几乎可以忽略不计的水平,最有效的方法是用含SA阳离子脂质体-AmB进行治疗。这种分泌IFN-γ的T细胞缺乏IL-10的环境可能上调了这些小鼠脾脏培养上清液中观察到的IL-12和NO的增强产生,这与比游离AmB和两性霉素脂质体更好的长期疾病抑制相关。该制剂引发保护性免疫的能力在预防性模型中得到了再次证实。我们的结果强调了通过抗利什曼原虫药物进行有效免疫刺激对于持续疾病保护的必要性,这种脂质体AmB制剂证明了这一点。

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